Hospice is not a place. It is a concept of caring for patients for whom medicine offers little relief and death is imminent within a few months. If this be said, palliative care has to extend beyond conventional understanding of what dying patients need from healthcare.
Rather than relying on constantly ramping up bed supplies, the way we handle vastly different palliative needs has to change. The new Outram Community Hospital (OCH), opening in 2020, aims to reduce hospital stays by conceiving care plans beyond the hospital. By creating a model 2-room flat where patients can practise activities of daily living such as getting around and cooking on crutches or even gardening, patients are imbued with confidence to return home earlier to continue these activities independently.
Of the 550 beds planned for OCH, only 50 beds will be reserved for patients who can step down to palliative care, resembling a hospice-within-a-hospital. HCA Hospice Care will complete the link by offering home hospice offices and a day hospice there.
OCH represents a major step forward in connected and customised palliative care. Its proximity to the Bukit Merah community which has the second-highest number senior residents in Singapore also means that its design and intentions will be especially relevant. These elderly have lived in the same flats for decades and are known to be attached to familiar environments. Being hospitalised near home and returning home as soon as possible is what they would wish for.
Research has highlighted that being free of pain and dying at home are important considerations for people nearing the end of their lives.
Hospice-type care can be given at the patient's home but different patients require different care. Patients with advanced dementia have multiple care needs that persist longer than six months. Long-term palliative home-care programs have to be specially designed to help them and their caregivers cope with enduring symptoms.
For final-stage cancer patients, it was sometimes assumed that life-extending treatments would be the primary concern but this could be wrong. A survey conducted by Professor Eric Finkelstein and Assistant Professor Chetna Malhotra from the Lien Centre for Palliative Care showed that caregivers are three times more willing to pay than patients to extend life by one year and for most of the other features mentioned. Patients tend to be concerned more with quality of life.
The results emphasized the need to seek out patients' preferences, and for patients, caregivers, and doctors to communicate more with one another. The survey also pointed to pain management, home death support, and other types of terminal care to support patients' wishes.
Doctor-patient collaborative healthcare is elemental for hospice care to exist outside hospitals and hospices. The Center for Connected Health at Partners HealthCare and a Massachusetts General Hospital (MGH) team are jointly creating a mobile app to help cancer patients manage chronic pain. Partners HealthCare's remote monitoring programs also enable patients to become collaborative partners in their care and its clinicians to assess the patient's health status accurately so as to deliver just-in-time care.
Innovations like these will revolutionise hospice care.
On a healthcare system level, digitization promises to help tear down the walls between different care silos. In many countries, this is still quite a challenge, both for political and technical reasons. HIMSS Insights eBook issue 7.4 will highlight healthcare systems that take connected care seriously and discuss the lessons to be learned from these leaders of change. We will also find out which technical standards are experiencing a tail wind, and how that is helping healthcare digitization to keep its promises. Download your copy of the eBook for free today to access the most insightful content and news: https://pages.healthcareitnews.com/HIMSSInsights4.html
Machine learning and artificial intelligence will massively influence the way healthcare is executed in the years to come. This is true for diagnostics, for medical therapy, and for population health management. This issue of Insights will address numerous tough and exciting questions around regulation, the algorithm black box, and what does it all mean for care delivery?
Healthcare digitization is still often perceived as being an endeavour on the level of the individual healthcare system or nation state. While there is some truth in that, it is equally obvious that a global digital health market is evolving, with vast opportunities for IT companies, healthcare providers, med-tech, pharma giants and even charities who are courageous enough to think big. In this edition of the HIMSS Insights eBook, we give these global eHealth champions a platform. Download your copy of the eBook for free today to access the most insightful content and news.
Paper health information presents significant challenges to large hospital environments. Due to the clinical risks that having a predominantly paper health record causes, Mater decided to take action to address the challenges of paper health records, which also resulted in significant increases in efficiency and cost reduction, all pre-dating the commencement of an EMR implementation. HIMSS Asia Pacific speaks with Sallyanne Wissmann, Director Information Management, Mater Health Services, Brisbane, ahead of her presentation at HIMSS AsiaPac18.